Three nations in three continents have seen attention focused on high suicide rates this week. A study found Scotland's suicide rate to be increasing away from neighbouring England, Russian press and politicians are examining the world's third-highest teen suicide rate, and new figures showed increasing Aboriginal children's suicides in Australia's Northern Territory.

"Until the highest authorities see suicide as a problem, our joint efforts will be unlikely to yield any results," Boris Polozhy of Moscow's Serbsky psychiatric center said yesterday. Only fellow ex-USSR nations Belarus and Kazakhstan have higher teen suicide rates than Russia, which is at around 20 per 100,000 nationally. Tuva, Siberia and nearby Buryatiya have rates of 120 and 77 per 100,000 respectively. Thursday saw national children's ombudsman Pavel Astakhov say 4,000 youths kill themselves each year.

I have seen websites that offer a thousand ways of killing oneself

—Zurab Kekelidze

Top Health Ministry psychologist Zurab Kekelidze yesterday responded to expert calls for action, promising to "very soon... start implementing" a plan of action to tackle the issue. He said Russian schools, which are criticised for understaffing and perceived inattention to bullying, should teach psychology.

Kekelidze asked the Russian Orthodox Church to help the suicidal, and severely criticised popular online forums dedicated to suicide, where methods are compared. "I have seen websites that offer a thousand ways of killing oneself," he claimed. Astakhov wanted schools to offer assistance via a social networking presence and tackle online bullying.

The overall national suicide rate is decreasing — down from 42 per 100,000 in 1995 to 23.5 two years ago. The high rate amongst teens is attributed to both school problems and violence at home. Recent high-profile cases include yesterday's death of a twelve-year-old who hung himself at home in Krasnoyarsk, Siberia, and two fourteen-year-olds who jumped hand-in-hand to their ends from a building in Lobnya, Moscow.

Around fifteen people jump to their deaths each year from Scotland's Erskine Bridge.Image: Baaker2009.

Researchers from the Scottish cities of Edinburgh and Glasgow, and Manchester in England, have been looking at data from 1960 to 2008. Although Scotland had the lower rate until 1968, England and Wales has had the lower rate since. Both areas had increasing rates until the southern side started to fall in the '90s, and in recent years the gap has significantly increased.

Data was sorted by age, gender, and method; marked increases were seen among Scotsmen aged from 25 to 54 with hanging increasing in popularity. The female rate has remained largely static.

"This study adds to our understanding about patterns of suicide in Great Britain by producing sound evidence on divergences in long-term trends in Scotland compared to England and Wales," said Professor Stephen Platt, a lead researcher from Edinburgh University's Centre for Population Health Sciences. "In a future companion paper we will suggest explanations for the persisting higher rate of suicide in Scotland."

Fellow joint lead researcher Roger Webb of the Centre for Suicide Prevention of Manchester University said the high Scottish hanging rate was "of particular concern as hanging has high case-fatality and is difficult to prevent, except within institutional settings." He noted "a public information campaign about hanging" could be one way of reducing the rate. Paid for by the Scottish taxpayer, the results appeared in the British Journal of Psychiatry.

Hanging is a popular method in Scotland and the Northern Territory, giving cause for concern among academics.Image: Chris 73.

In an incident with parallels to the recent Moscow deaths, in 2009 Scottish and British media publicised a high-profile case in which two teenagers leap together from the Erskine Bridge, a famed suicide spot over the River Clyde where an estimated fifteen people kill themselves each year.

We now have a situation in the territory where there are almost as many female as male suicides

—Howard Bath

This week also saw Howard Bath, Children's Commissioner for Australia's Northern Territory, suggest the area had the highest proportion of Aborignal girl suicides in the West. There has been a significant increase since an emergency intervention five years ago in response to a report titled Little Children are Sacred which documented widespread sexual abuse of Northern Territory children and failures by authorities to adequately respond.

A national government-backed Northern Territory suicide inquiry is ongoing and due to report next month. The inquiry has heard clusters of deaths occurred around East and West Arnhem, Katherine, and the vicinity of Alice Springs. The Tiwi Islands had a very high rate from 2000 to 2005, but has now not had a suicide for a year.

Female suicide rates have greatly increased to account for 40% of Northern Territory suicides amongst those aged less than eighteen. "We now have a situation in the territory where there are almost as many female as male suicides," said Bath. Lack of information is a problem; the all-party inquiry has heard evidence of much under-reporting and poor data collection. The Menzies School of Health's Gary Robinson called for a Queensland-style register of suicides.

Robinson suggests cannabis-induced psychosis to be a contributing factor but laments "The big problem is nobody keeps any data. Everything is based on impressions." He also suggested bullying, as in Russia, is a problem while Bath notes violence against women may also take a role. "Aboriginal women are being hospitalised for assault at 80 times the rate of other women... Exposure to violence greatly increases the risk of a person taking their life." He also notes "I am concerned, as the commissioner, about children who are frequently exposed to violence in the home or in the immediate family."

As with Scotland, hanging is a popular choice. "The method chosen is usually hanging and it is a particularly lethal method, far more than an overdose," said Bath. New South Wales, with the nation's largest indigenous population, has a suicide rate of one per 100,000 but the Northern Territory rate is over 30 per 100,000.

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